Drug resistance and drug resistance genes in Acinetobacter baumannii strains form ICU and non-ICU patients:a comparative study
OBJECTIVE To retrospectively analyze the differences in drug resistance and expressions of drug resist-ance genes and efflux pump genes in Acinetobacter baumannii isolates between the intensive care unit(ICU)pa-tients and the non-ICU patients so as to provide scientific bases for reasonable clinical use of antibiotics and control of multidrug-resistant organisms(MDROs).METHODS Totally 213 strains of A.baumannii that were isolated from the patients with lower respiratory tract infection who were hospitalized in the Third Affiliated Hospital of Sun Yat-sen University from Jan 2009 to Mar 2014 were divided into the ICU group with 82 strains and the non-ICU group with 131 strains according to the source of the strains.The drug resistance of the strains was detected.The expressions of drug resistance genes(OXA-23,OXA-24,OXA-48,OXA-51,OXA-58,OXA-143,OXA-235,NDM-1,KPC,IMP,VIM,GIM-1,SPM-1,SIM-1,FIM-1,ISAba1 and ISAba4),efflux pump genes(adeB,adeJ,adeG,craA,abeM and amvA)and outer membrane protein genes(omp 25,omp33 36,carO)were detected.RESULTS The drug resistance rate of the A.baumannii strains of the ICU group was 90.2％to imipenem,significantiy higher than that of the strains of the non-ICU group(x2=7.117,P=0.008).The detec-tion rate of the drug resistance gene OXA-51 was more than 95％in the ICU group and the non-ICU group;the detection rate of OXA-23 was 80.0％in the ICU group,60.3％in the non-ICU group(P=0.007);the detection rate of VIM was 50.0％in the ICU group,29.0％in the non-ICU group(P=0.002).OXA-48,OXA-143,OXA-235,KPC,NDM-1 and SIM-1 genes were not detected.There was significant difference in the relative ex-pression level of adeB between the ICU group and the non-ICU group(P＜0.05).CONCLUSION There are sig-nificant differences in the drug resistance rate to imipenem,expressions of drug resistance genes(OXA-23,VIM)and efflux pump gene adeB between the A.baumannii strains isolated from the ICU group and the strains isolated from the non-ICU group.It is suggested that the above drug resistance mechanisms may be the causes of high drug resistance rates of the A.baumannii strains isolated from the ICU patients.
Acinetobacter baumanniiDrug resistanceIntensive care unitDrug resistance geneEfflux pump
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